Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Prevalence of gastrointestinal parasitic infections and assessment of deworming program among cattle and buffaloes in Gampaha District, Sri Lanka(Hindawi Publishers, 2018) Gunathilaka, N.; Niroshana, D.; Amarasinghe, D.; Udayanga, L.Gastrointestinal (GI) parasitic infection is a serious issue in cattle management. The effects of GI parasites may vary with age, sex of cattle, nutritional condition, and severity of infection. Prevalence of GI parasites among cattle population in Gampaha District has not been studied and there is no published study available. A total of 45 farms rearing cattle were selected randomly in three areas, namely, Kelaniya, Ganemulla, and Welisara, under three Veterinary Surgeon Divisions (VSD) in Gampaha District (Mahara, Gampaha, and Welisara). Freshly voided cattle fecal samples were collected randomly from the selected farms during March 2017–December 2017. Out of 163 cattle and buffaloes examined, 13.39% (n=22) were positive for eggs of one or more species of GI parasites. The prevalence of parasitic infection was higher in buffaloes (31.25%, 5/16) as compared to that of cows (11.56%, 21/147), but the difference was not significant (P >0.05). Hookworms (Bunostomum spp.), whipworms (Trichuris spp.), digenetic trematodes (Paramphistomum spp.), cestodes (Moniezia spp.), and oocysts of protozoans (coccidians) were found during the study. The nontreated animals indicated the highest percentage of parasitic infections accounting for 46.67% (n= 14), followed by partially treated individuals (15.15%, n= 5). GI parasite prevalence in males was higher when compared to that of females, but the difference was nonsignificant (P >0.05). General Linear Modelling (GLM) revealed that the effect of treatment status was significantly associated with the prevalence of GI parasites. The calves and yearlings had the highest rate of GI parasitic infections. The highest infection rate was observed at Kelaniya, followed by Welisara. Future investigations are necessary to evaluate the economic impact of GI parasites in the study areas.Item Intestinal parasitic infections in primary school children in Mahiyangana district(Sri Lanka College of Microbiologists, 2000) Chandrasena, T.G.A.N.; Morel, R.P.; de Alwis, C.; Sudusinghe, H.P.; de Silva, N.R.Item The Costs and cost-cffectiveness of mass treatment for intestinal nematode worm infections using different treatment thresholds(Public Library of Science, 2009) Hall, A.; Horton, S.; de Silva, N.BACKGROUND: It is estimated that almost a half of all of people living in developing countries today are infected with roundworms, hookworms, or whip worms or combinations of these types of intestinal nematode worms. They can all be treated using safe, effective, and inexpensive single-dose generic drugs costing as little as USD 0.03 per person treated when bought in bulk. The disease caused by intestinal nematodes is strongly related to the number of worms in the gut, and it is typical to find that worms tend to be aggregated or clumped in their distribution so that <20% of people may harbour >80% of all worms. This clumping of worms is greatest when the prevalence is low. When the prevalence rises above 50%, the mean worm burden increases exponentially, worms are less clumped, and more people are likely to have moderate to heavy infections and may be diseased. Children are most at risk. For these reasons, the World Health Organization (WHO) currently recommends mass treatment of children > or =1 year old without prior diagnosis when the prevalence is > or =20% and treatment twice a year when the prevalence is > or =50%. METHODS AND FINDINGS: The risk of moderate to heavy infections with intestinal nematodes was estimated by applying the negative binomial probability distribution, then the drug cost of treating diseased individuals was calculated based on different threshold numbers of worms. Based on this cost analysis, a new three-tier treatment regime is proposed: if the combined prevalence is >40%, treat all children once a year; >60% treat twice a year; and >80% treat three times a year. Using average data on drug and delivery costs of USD 0.15 to treat a school-age child and USD 0.25 to treat a pre-school child (with provisos) the cost of treating children aged 2-14 years was calculated for 105 low- and low-middle-income countries and for constituent regions of India and China based on estimates of the combined prevalence of intestinal nematode worms therein. The annual cost of the three-tier threshold was estimated to be USD 224 million compared with USD 276 million when the current WHO recommendations for mass treatment were applied. CONCLUSION: The three-tier treatment thresholds were less expensive and more effective as they allocated a greater proportion of expenditures to treating infected individuals when compared with the WHO thresholds (73% compared with 61%) and treated a larger proportion of individuals with moderate to heavy worm burdens, arbitrarily defined as more than 10 worms per person (31% compared with 21%).Item A Review and meta-analysis of the impact of intestinal worms on child growth and nutrition(Wiley-Blackwell, 2008) Hall, A.; Hewitt, G.; Tuffrey, V.; de Silva, N.More than a half of the world's population are infected with one or more species of intestinal worms of which the nematodes Ascaris lumbricoides, Trichuris trichiura and the hookworms are the most common and important in terms of child health. This paper: (1) introduces the main species of intestinal worms with particular attention to intestinal nematodes; (2) examines how such worms may affect child growth and nutrition; (3) reviews the biological and epidemiological factors that influence the effects that worms can have on the growth and nutrition of children; (4) considers the many factors that can affect the impact of treatment with anthelmintic drugs; (5) presents the results of a meta-analysis of studies of the effect of treating worm infections on child growth and nutrition; (6) discusses the results in terms of what is reasonable to expect that deworming alone can achieve; (7) describes some important characteristics of an ideal study of the effects of deworming; and (8) comments on the implications for programmes of recommendations concerning mass deworming.Item Geo-helminth infections in a rural area of Sri Lanka(SEAMEO Regional Tropical Medicine and Public Health Project, 2001) Fernando, S.D.; Goonethilleke, H.; Weerasena, K.H.; Kuruppuarachchi, N.D.; Tilakaratne, D.; de Silva, D.; Wickremasinghe, A.R.School children carry the heaviest burden of morbidity due to intestinal helminth infection. The objective of this investigation was to study geo-helminth infections in 349 school children aged 6 to 13 years living in a rural area of Sri Lanka. Stool samples were examined by direct saline smear in an initial survey to determine the prevalence of intestinal parasitic infections and thereafter the children were followed up over a two year period with cross sectional surveys of stool samples being carried out at yearly intervals. Following collection of a stool sample, all the subjects were treated with mebendazole 500 mg as a single dose. Weights and heights were measured using standardized procedures. 2 ml of venous blood were collected from each subject under aseptic conditions to determine hematological indices. The prevalence of geo-helminth infections was low, and the prevalence declined during the two-year period from 5.4 percent in 1997 to 2.2 percent in 1998 and 2.0 percent in 1999 following yearly mass anti-helminth treatment. The incidence density was 0.021 cases per child year. The reduction in the prevalence from the baseline to the second survey is probably due to the reduction of the reservoir of infection among children as a result of mass treatment at baseline. The prevalence of infection during the second and third surveys were almost the same probably due to infections originating from other segments of the untreated population.Item Intestinal helminth infections among children in a slum community in Enderamulla(Sri Lanka Medical Association, 1999) Udayani, W.I.; Uduwevidane, K.; Uvais, A.L.; Wanniarachchi, S.L.; Warnakulasuriya, S.N.; de Silva, N.R.No Abstract availableItem Childhood intestinal infections in Sri Lanka(Galle Medical Association., 1997) de Silva, H.No Abstract availableItem Morbidity and mortality due to Ascaris-induced intestinal obstruction(Oxford University Press, 1997) de Silva, N.R.; Guyatt, H.L.; Bundy, D.A.P.We examined epidemiological aspects of Ascaris-induced intestinal obstruction (AI-IO) through analysis of published reports on the subject. In 9 studies of > or = 100 patients admitted to hospital due to ascariasis, intestinal obstruction was the single most common complication and accounted for 38-87.5% of all complications (weighted mean 72%). The proportion of intestinal obstruction caused by ascariasis was identified in 14 studies from 7 countries with varying degrees of endemic ascariasis. Using relevant data on the duration of the study, the number of beds in the reporting hospital, and the number of hospital beds/1000 population in the area, the number of cases of AI-IO/year/1000 population was estimated from 11 studies. Both the proportion of AI-IO (range 0-0.71) and the number of cases of AI-IO/year/1000 population (range 0-0.25) were significantly related, in a non-linear manner, to the local prevalence of ascariasis (range 0.01-0.92). In 12 studies of > or = 30 patients with AI-IO, the case fatality rates ranged from 0 to 8.6% (weighted mean 5.7%). The mean age of patients with AI-IO was < or = 5 years in 6 of 7 studies in which age was specified.Item Intestinal worms: our turn to turn(Sri Lanka Medical Association, 1995) de Silva, H.J.; de Silva, N.R.No Abstract AvailableItem Prevalence patterns of intestinal parasitoses among school children in Mahaweli System C: a new settlement in Sri Lanka(The Kandy Society of Medicine, 1993) Wijesundera, M. de S.; de Silva, N.R.; Ariyaratne, C.S.SUMMARY: Studentsattending three schools in the settlements of Bakmeedeniya, Ranhelagama and Nagaswewa in Mahaweli System C, were examined at approxi¬mately yearly intervals from December 1986 to November 1989, to assess the prevalence patterns of intestinal parasitoses in the area. The age of the students at the time of examination ranged from 5-19 years, with 89% being in the 5-14 year age group. The male:female ratio was 1:1.1. Faecal smears in saline and iodine were examined for protozoan cysts and helminth ova. Children positive for pathogens were given appropriate therapy. A total of 765 stool samples (from 496 children) were examined: 203 in 1986/87, 365 in 1988 and 197 in 1989. The prevalence of the soil-transmitted helminths was very low throughout, and the rates facAscarislumbricoides, Trichuristrtehiura and hookworm infection was always less than 4 %. Of the intestinal protozoan parasites, the cysts most commonly seen were those of Entamoeba coli, which was found at rates of 16%, 13% and 10% in 1986/87,1988 and 1989 respectively. The commonest pathogenic protozoan was however Giardia intestinalis (positivity rates: 10%, 10% and 8% respectively). lodamoeba butschlii was also detected at low levels, the rates being 3%, 1 % and 2% respectively. E. histolytica was not seen.